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More Hepatitis B Testing, Tx Adherence Needed for Veterans

Rates of serologic testing for hepatitis B virus (HBV) conducted by the U.S. Department of Veterans Affairs (VA) were found to be suboptimal as recommended by the American Association for the Study of Liver Diseases (AASLD) practice guideline, according to a presentation at the AASLD Liver Meeting in Boston, MA.

Dr. David E. Kaplan, of the University of Pennsylvania and Philadelphia VA Medical Center, and colleagues found that HBV infection is twice as likely in the veteran population as compared to the general population across the country. According to the AASLD practice guidelines on hepatitis B, an initial positive result on the Hepatitis B Surface Antigen (HBsAg) test requires additional confirmation testing. The study showed that out of the 2.5 million veterans who had the HBsAg test, about 1% (n=26,7272) tested positively for hepatitis B. Of that group, the follow-up tests were not done as frequently as recommended by the the AASLD. Further, the data showed only 25% of patients received antiviral therapy.

Study authors suggested that based on these results of the VA, there is a "significant population of injection drug use-related chronic HBV that is undiagnosed" among the general baby boomer population. In addition to the under-diagnosis, researchers reported up to 70% of HBsAg tests are not followed by referral from primary care to gastrointestinal or infectious disease specialists.

It was concluded that the rate of follow-up testing for those who initially test positive for HBV is low, as well as general adherence to recommendations on antiviral treatment.